Placing sexuality in health policies:: Feminist geographies and public health nursing

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Despite the increasing public profile of same-sex issues, health policies are often shaped by heteronormative assumptions. The health concerns of lesbian, gay, bisexual, transsexual/transgender, two-spirit, intersex, queer and questioning (LGBTTTIQQ) people are complex and require broadening from an often exclusively sexual health and risk focus to a more holistic approach. In this context, this paper illustrates how a critical feminist geography of health, with its focus on the mutual construction of gender relations, space and place, potentially enhances and extends current understandings of public health policy and practice. Moreover, the use of a policy lens foregrounding gender and other power relations suggests that feminist research and coalitions facilitate participatory processes that address “the politics of discourse.” In particular, public health nursing practice can enhance the construction of spaces of resistance that challenge heteronormative discourse through research strategies focused on sexual minority communities' health experiences and their visions for supportive care. In this respect, two strategies consistent with public health priorities to increase knowledge and participate in alliances are described. Ethnographic research with childbearing lesbians demonstrates that attention to institutional dynamics that foster safe spaces can facilitate access to public health services. Public health nurses' involvement in community coalitions can enhance dissemination of community knowledges. The implications for gender inclusive and place-sensitive public health nursing practice include the development of sensitive educators, meaningful educational curriculum and related program planning, explicit policies, community partnerships and political leadership in institutional and research venues.

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